Can Immune Tolerance Be Re-established in Neuromyelitis Optica?
Can Immune Tolerance Be Re-established in Neuromyelitis Optica?
复制标题
DOI：
10.3389/fneur.2021.783304
复制
发表时间：
2021
影响因子：
3.4
通讯作者：
Balabanov R
中科院分区：
文献类型：
--
作者：
Loda E;Arellano G;Perez-Giraldo G;Miller SD;Balabanov R
视神经肌病（NMO）是中枢神经系统的慢性炎性疾病，其主要影响患者的视神经和脊髓，并且在某些情况下影响患者的脑干、间脑或大脑作为谱系障碍（NMOSD）。在过去的二十年里，NMO的临床和基础科学知识急剧增加，它改变了对该疾病不可避免地致残或致命的看法。尽管如此，仍然没有治愈NMO的方法，所有的疾病修饰疗法（DMT）都只是部分有效。此外，DMT不是疾病特异性或抗原特异性的，并且改变所有免疫应答，包括对感染和癌症的保护性免疫应答，并且通常与显著的不良反应相关。在这篇综述中，我们讨论了NMO的致病机制，因为它们涉及到它的DMT和免疫耐受。我们还研究了新的研究治疗策略，重点是通过给予致耐受性免疫修饰纳米颗粒（TIMP）诱导抗原特异性免疫耐受。在NMO中开发和实施基于免疫耐受的疗法可能是改善疾病治疗结果的重要一步。这些疗法的抗原特异性将可能安全有效地改善疾病，并且还将消除与慢性免疫抑制疗法相关的临床挑战。
Neuromyelitis optica (NMO) is a chronic inflammatory disease of the central nervous system that primarily affects the optic nerves and spinal cord of patients, and in some instances their brainstem, diencephalon or cerebrum as spectrum disorders (NMOSD). Clinical and basic science knowledge of NMO has dramatically increased over the last two decades and it has changed the perception of the disease as being inevitably disabling or fatal. Nonetheless, there is still no cure for NMO and all the disease-modifying therapies (DMTs) are only partially effective. Furthermore, DMTs are not disease- or antigen-specific and alter all immune responses including those protective against infections and cancer and are often associated with significant adverse reactions. In this review, we discuss the pathogenic mechanisms of NMO as they pertain to its DMTs and immune tolerance. We also examine novel research therapeutic strategies focused on induction of antigen-specific immune tolerance by administrating tolerogenic immune-modifying nanoparticles (TIMP). Development and implementation of immune tolerance-based therapies in NMO is likely to be an important step toward improving the treatment outcomes of the disease. The antigen-specificity of these therapies will likely ameliorate the disease safely and effectively, and will also eliminate the clinical challenges associated with chronic immunosuppressive therapies.
登录
查看更多内容
影响因子：
5.1
作者：
Billi AC;Kahlenberg JM;Gudjonsson JE
通讯作者：
Gudjonsson JE
影响因子：
4.4
作者：
Fujihara, Kazuo
通讯作者：
Fujihara, Kazuo
影响因子：
16.8
作者：
Axtell RC;Raman C;Steinman L
通讯作者：
Steinman L
影响因子：
6.700
作者：
A. Mota
通讯作者：
A. Mota
影响因子：
4
作者：
Brod SA
通讯作者：
Brod SA